Comprehensive Mental Status Examination

A comprehensive mental status examination begins with a patient’s outer appearances and progressively proceeds into their interior life. A clinician must carefully observe and thoughtfully question a patient, all the while keeping in mind cultural context, developmental stage, and educational level. A clinician can organize their experience of a patient’s mental state using their own version of the format outlined below, which includes definitions for the essential terms for the mental status examination.

Ability to relate socially during your encounter
Ambulatory status and, if possible, gait
Catalepsy (maintenance of any physical position after being moved by examiner)
Posturing (striking a pose and maintaining it)
Drooling
Mannerisms (unnecessary behaviors that are part of goal-directed behaviors)
Presence of waxy flexibility (resistance of limbs to passive motion that improves with ongoing movement)
Psychomotor agitation (excessive physical activity accompanied by inner tension)
Psychomotor retardation (generalized slowing of cognitive, emotional, or physical responses)
Stereotypies (non-goal-directed behaviors that are unusual in frequency, but not in the action itself)
Signs of extrapyramidal symptoms or tardive dyskinesia
Tics (involuntary, recurrent, nonrhythmic movement or vocalization)
Tremor

Mutism (absence of speech)
Alliteration
Aphonia (ability to only whisper or croak)
Thought blocking (sudden stops in the middle of a thought sequence)
Clang association (words chosen purely for sound)
Decreased latency of response (answering questions before you can finish asking them)
Increased latency of response (long pauses before fairly normal speech)
Derailment (running ideas into each other)
Distractibility (being easily diverted by extraneous stimuli)
Echolalia (repetition of words or statements of others)
Flight of ideas (an illogical group of associations)
Associations may be described as intact, circumstantial (providing unnecessary details but eventually answering a question), tangential (only initially responding to a question), or loose (providing responses unrelated to a question), or even word salad (random use of words)
Neologisms (creation of words)
Perseveration (repetition of the same motor or verbal response despite varied stimuli)
Poverty of speech (brief, concrete responses with limited spontaneous speech)
Push of speech (increased, rapid speech that is often loud and difficult to interrupt)
Verbigeration (prolonged repetition of isolated words)

Compulsions (irresistible impulses to perform a behavior)
Obsessions (recurrent, persistent idea, image, or desire that dominates thought)
Delusions (fixed, firm, false beliefs that are not part of a person’s culture or religion)
Grandiosity
Guilt
Hallucinations (perceptions of an absent stimulus
Illusions (misperceptions of an actual stimulus)
Ideas of persecution
Ideas of reference (perceptions that unrelated stimuli have a particular and unusual meaning specific to the person)
Ideation, intent, or plan to harm self or others (suicidal, homicidal, or violent)
Paranoia
Passivity (submissive attitude to a perceived superior
Phobias (intense, unreasonable, specific fears)
Thought insertion (perceiving that your thoughts are not your own, but inserted into your mind by others)
Thought withdrawal (perception that others can take thoughts out of your mind without consent)

Ability to abstract and to interpret culturally—and educationally— appropriate proverbs
Ability to calculate
Ability to read and write
Fund of general information
Learning style
Impulse control
Orientation
Recent and remote memory

Insight into their condition, especially as to whether they deny or appreciate their problem
Judgment (mental ability to compare choices and make appropriate decisions) as related to presenting condition and age